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Distressed patients forced Dr Omar Zuaiter to leave clinical dentistry, freeing him up to eventually develop the Dentroid device with the potential to change the profession for the better. By John Burfitt
It was a conversation he had back in 2015 during which Dr Omar Zuaiter complained about the lack of technological progress within dentistry to his engineering friend Alaa Habeb that set the wheels in motion for the innovative work the pair have since undertaken, which they believe could revolutionise the practice of dentistry.
“I was explaining the difficulties we face working as dentists, stating I don’t think technological improvements have served us well in comparison with other medical professions,” recalls Dr Zuaiter.
“I said that dentists, by and large, still work in a 19th century fashion as dental innovation has just seemed to stop. That was when Alaa responded, ‘Well, why don’t we do something about it?’ I thought he was crazy, but that chat sparked something and within days, we were looking into how much more robotic dentistry could achieve.”
That conversation was eight years ago. Today, the two are co-founders of Dentroid, a company that has just wrapped up phase one clinical trials where they—in collaboration with Griffith University School of Dentistry—are putting some of their groundbreaking technologies to the test on 33 patients in Adelaide and on the Gold Coast. Phase two trials are scheduled to commence in the coming months.
“The results from phase one—testing non-invasive photonic anaesthesia—exceeded all expectations,” says Dr Zuaiter. “After the first day, the chief examiner called to say it was working consistently well, and it was the same on all the days after that. We became reasonably confident that a revolution in dentistry was underway and happening here in Australia.”
The Dentroid device is a miniaturised tooth-mounted robot powered by advanced photonics, artificial intelligence (AI), sensor fusion and imaging techniques. The device is anchored in the mouth, placed in specific areas that require treatment, and works by scanning a tooth and using AI to highlight pathology.
It then recommends a minimally invasive preparation and restoration process, utilising advanced laser and miniature robotics to complete the treatment.
Most of the process is done by a femtosecond laser, removing soft and hard tissues using ultra short pulses to avoid over-heating the tooth, and removing the minimum amount of enamel and dentine in the process. The main procedures the device will be suitable for are treatment of cavities, preparing crowns and performing endodontic therapy.
The process is so precise it will also allow the dentist to deliver prefabricated fillings and crowns, and automatically prepares the tooth without the need for water or anaesthesia, or the use of traditional tools such as needles, drills or water sprays. In doing so, it promises a pain-free procedure for the patient.
Into the future, it’s anticipated Dentroid may also offer a reliable platform for portable dentistry that may be effective in delivering oral care to rural and remote communities.
“We just think this is a better way of doing dentistry, and dentistry currently has a range of big problems including its image, productivity and economics,” says Dr Zuaiter. “This is a hands-free, minimally invasive way of doing our work which will remove much of the need for having the dentist’s hands inside the patient’s mouth. It will be cameras and other diagnostic tools that will help us to focus the lasers into the areas that require attention.”
Dr Zuaiter explains this way of working offers a number of benefits, including increased productivity. It means potentially starting a consultation long before the patient has even stepped inside the clinic. He says the technology will allow patients to send through data before an appointment, for the analytics to begin which can then be implemented once the in-clinic appointment commences.
“This way can be much easier for the patient and easier for the dentist, and also offers the potential for more consultations to be completed throughout the day, without anything being hurried,” he says. “I’m sure streamlining the entire experience would be welcomed.”
Dr Zuaiter hopes Dentroid’s greatest benefit will be pain-free dentistry which removes the need for needles and drills in the majority of cases, along with the fear so often associated with going to the dentist.
“This way allows high-quality dentistry to be achieved without the need for invasive hands or drills, needles, the noise, vibrations, and the general distress created by all of that. When you’re using gentle laser rays of light to do the job, the difference is there’s no energy or vibration travelling down the nerves.”
At the end of the phase one trial, when patients were asked to measure their experience on a pain scale, all reported zero pain.
“We want to change that perception about dentistry and pain. We want to make it easier and friendlier and enable people to have the best oral hygiene possible.”
Addressing the issue of pain within dentistry is a cause close to Pakistan-born, Jordanian-raised Dr Zuaiter’s heart. After graduating from the Dental School at the Jordan University of Science and Technology in 2003, he worked in general practice and later in public health. The experience, however, was so difficult that he moved out of practice and into policy advocacy work.
“I just found it so tough to finish a procedure when I had put my heart and soul into it and was happy with the result, only to have patients exclaim, ‘That was horrible; I always hate coming to the dentist’,” he says. “I also had a colleague who spent hours treating his mother for a root canal, and afterwards she complained going to the dentist was worse than having major surgery. When you hear comments like that day after day, it offers little incentive to stay in the profession.”
After he moved to Australia in 2013, he did a Master of Public Policy/Development Policy at the Australian National University, completed new training at Melbourne’s Royal Dental Hospital, and continued his work in policy advocacy. “This was when I began thinking there just had to be a better way of doing dentistry and, with no idea really where to commence, we started the journey of looking into new ways of utilising the technology that existed.”
With phase two of the trial now about the commence, Dr Zuaiter is busy conducting presentations to introduce the concept of Dentroid to the profession. Some of the responses, however, have been mixed.
“In dentistry, we are trained to be conservative and sometimes working with technology has its challenges with clinicians and academics,” he says. “One person said we are taking the art out of dentistry, and another claimed we are making dentistry like a video game, using lasers to shoot the bad guys!”
Younger dentists and new graduates, however, have had a dramatically different reaction. “They get it and are willing to adopt new procedures as technology is second nature to them and they are thrilled by the prospect of what this can do now, and curious about what it can do into the future. That’s when I get excited as I know we are involved in a revolution that will shape the future of our profession.”
After the phase two trial is complete by the end of the year, phase three is scheduled for early 2023. All going well with clinical evidence, report analysis and regulatory approvals, Dr Zuaiter predicts Dentroid products could be on the market by mid-2025. He won’t, however, be drawn in on the subject of cost, claiming it’s too premature to make any financial predictions.
“What I do know, however, is this will be a good investment not only in terms of making the entire experience more seamless and safer for the patient and dentist, but also in the overall productivity that will be achieved.
“There is still much more work to be done but change is on the way and it is something to welcome, not worry about. What we have seen so far is so encouraging.”